Cognitive behavioral therapy for depressed adolescents exposed to interpersonal trauma: An initial effectiveness trial.

Abstract

Four clinical trials have shown that a history of interpersonal trauma is associated with diminished response to cognitive-behavioral therapy (CBT) for adolescent depression. An efficacious CBT protocol for adolescent depression was modified to address cognitive deficits and distortions associated with interpersonal trauma. Initial feasibility, acceptability, and treatment impact of the modified treatment (m-CBT) were evaluated in a randomized effectiveness trial conducted in community clinics. Clients were 43 referred adolescents with a depressive disorder and a history of interpersonal trauma. Adolescents either received m-CBT or usual care (UC) therapy. Results indicated that m-CBT was delivered with good fidelity by community clinicians, but that number of sessions completed was attenuated in both m-CBT and UC. Adolescents reported high levels of treatment satisfaction and acceptability for the new treatment. There were significant reductions in depressive symptoms over time, but no differences in outcomes between groups. Although the new treatment produced promising results, it did not outperform UC. Implications for treatment development are considered.

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

“…Six 112,[114][115][116][117]120 of these studies recruited both male and female children or their carers. Some had a preponderance of one gender, for example the samples in the studies by Shirk et al 117 and Farkas et al…”

“…CBT for children with maltreatment histories, including those with experience of multiple forms of maltreatment and those that recruit children irrespective of type of maltreatment history. [110][111][112][114][115][116][117]121,176 Description of studies…”

“…Nine randomised trials of CBT or enhanced CBT interventions were identified [110][111][112][114][115][116][117]120,121 that were designed to address the consequence of maltreatment, irrespective of maltreatment type. The studies were themselves heterogeneous, and fall into four broad categories:…”

“…interventions to enhance the parenting skills of foster parents and adopters, in order to help them address the particular challenges of parenting children with maltreatment histories 112,[114][115][116] 2. interventions addressing PTSD and associated symptoms in maltreated young people 111,117 3. risk reduction interventions to reduce human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) among abused and neglected young people 110 4. studies of EMDR.…”

“…We identified 26 controlled studies [90][91][92][93][94][95][96][97][98][99][100][101][102][103][106][107][108][109][110][111][112][114][115][116][117]121,176,268 of cognitive-behavioural interventions (CBT), of which 23 were randomised trials. There were sufficient randomised trials to attempt to explore the differential effect on different maltreatment histories, broadly defined, and so this section is organised into the following three groupings, and does not include the three COSs of CBT interventions.…”